How can a male prevent and treat gonorrhea and chlamydia acquired through oral sex from a female?

From the Guidelines

To prevent and treat gonorrhea and chlamydia acquired through oral sex from a female, a male should use barrier protection like condoms during oral sex and seek prompt antibiotic treatment if infection occurs, with the recommended treatment being Ceftriaxone 125 mg IM in a single dose for gonorrhea, and Azithromycin 1 g orally in a single dose or Doxycycline 100 mg orally twice daily for 7 days for chlamydia, as suggested by the CDC guidelines 1.

For prevention, using condoms or dental dams during oral sex significantly reduces transmission risk. If exposed or symptomatic, testing is essential as these infections can be asymptomatic.

• Key points to consider:
  • Gonorrhea and chlamydia can be transmitted through oral sex, and using barrier protection can reduce this risk.
  • If infection occurs, prompt antibiotic treatment is necessary to prevent complications.
  • The CDC recommends specific treatment regimens for gonorrhea and chlamydia, including Ceftriaxone, Azithromycin, and Doxycycline 1.
  • Regular STI testing is recommended for sexually active individuals, especially after new partners, as early detection prevents complications like urethritis, epididymitis, or systemic infection 1. It's also important to note that patients who have uncomplicated gonorrhea and who are treated with any of the recommended regimens need not return for a test to confirm that they are cured, but patients who have symptoms that persist after treatment should be evaluated by culture for N. gonorrhoeae, and any gonococci isolated should be tested for antimicrobial susceptibility 1.

In terms of management of sex partners, patients should be instructed to refer their sex partners for evaluation and treatment, and all sex partners of patients who have N. gonorrhoeae infection should be evaluated and treated for N. gonorrhoeae and C. trachomatis infections if their last sexual contact with the patient was within the recommended time frame 1.

Regular screening for chlamydia and gonorrhea is also recommended, especially for high-risk populations, such as men who have sex with men, and sexually active females aged 25 years or younger 1.

Overall, prevention, prompt treatment, and regular screening are key to reducing the risk of gonorrhea and chlamydia transmission and preventing complications.

From the FDA Drug Label

Uncomplicated gonococcal infections in adults (except anorectal infections in men):100 mg, by mouth, twice a day for 7 days. Uncomplicated urethral, endocervical, or rectal infection in adults caused by Chlamydia trachomatis: 100 mg, by mouth, twice a day for 7 days. Urethritis and cervicitis due to Chlamydia trachomatis or Neisseria gonorrhoeae.

To prevent gonorrhea and chlamydia acquired through oral sex from a female, safe sex practices such as using dental dams or condoms are recommended. If infection occurs, treatment with doxycycline 100 mg, by mouth, twice a day for 7 days 2 or azithromycin as recommended by a healthcare professional 3 may be effective. It is essential to note that antibiotic treatment should only be initiated under the guidance of a healthcare professional, as they will determine the most suitable treatment based on the specific infection and patient factors. Regular testing for sexually transmitted infections (STIs) is also crucial for individuals who engage in high-risk sexual activities.

From the Research

Prevention of Gonorrhea and Chlamydia

• To prevent gonorrhea and chlamydia acquired through oral sex from a female, the use of protection such as condoms or dental dams is recommended 4, 5.
• Oral health is also an important factor in preventing the transmission of these infections, as a healthy oral cavity can reduce the risk of infection 5.
• Avoiding oral sex during therapy for bacterial sexually transmitted infections can also help prevent re-infection 4.

Treatment of Gonorrhea and Chlamydia

• The recommended treatment for gonorrhea is ceftriaxone monotherapy given intramuscularly, with dosing based on the patient's body weight 6.
• For chlamydia, doxycycline is the preferred treatment 6.
• Azithromycin 2.0 g orally is also effective in the treatment of uncomplicated gonorrhea and chlamydial infection, but it is associated with a relatively high frequency of gastrointestinal side effects 7.
• A test-of-cure is recommended for all cases of pharyngeal gonorrhea and for rectal chlamydia if treated with azithromycin 6.

Transmission and Risk Factors

• Gonorrhea and chlamydia can be transmitted through oral sex, and the risk of transmission can be increased by certain factors such as poor oral health and the use of saliva as a lubricant 5, 8.
• The majority of gonorrhea and chlamydia cases among men who have sex with men are extragenital and occur at the oropharynx and anorectum 8.
• Novel interventions for gonorrhea that reduce the risk of transmission at extragenital sites are required, as condoms may not be effective in preventing gonorrhea transmission to these sites 8.